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Öğe Correlation between developmental stages of the human heart and gestational ages(SAUDI MED J, 2005) Uysal, II; Karabulut, AK; Salbacak, A; Buyukmumcu, M; Seker, MObjectives: In this study we aimed to investigate the normal developmental pattern of the human fetal heart in second and third trimester, and to evaluate the correlation of the values with the gestational age (GA). Methods: Seventy spontaneously aborted human fetuses with no external malformations were investigated and 11 parameters from each were assessed. The relationship of these parameters with the GA was evaluated by linear regression and correlation analyses using statistical methods. In addition, the values were compared to the gender and sides of the heart using Student t-test. This study was performed at the Department of Anatomy, Meram Medical Faculty, Selcuk University, Konya, Turkey, during the period from 2000 to 2004. Results: There was a statistically significant linear relationship between the heart wall thicknesses, the development of the valves of the heart and GA. The mean values of the right side of the heart were found to be higher than those of the left side, and differences were statistically significant (p < 0.05). Although, most of the parameters were found to be higher in females, only 2 of them were statistically significant. All parameters of the cardiac valves measured were significantly higher in the second trimester. There was no difference regarding the correlation ratio of the trimesters between the pulmonary valve diameter and GA. The measurement of the cardiac valves did not show any differences regarding the gender. Conclusion: This study presents the normal values of the development of the fetal heart in second and third trimester that may provide useful background information for clinical approaches.Öğe An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance(URBAN & FISCHER VERLAG, 2005) Cicekcibasi, AE; Ziylan, T; Salbacak, A; Seker, M; Buyukmumcu, M; Tuncer, IWe investigated the origin, localizations and anatomic variations of the renal artery (RA) in human fetuses with the aim of determining the distribution of these variations according to lateralization and gender. In total, 90 fetuses of spontaneous abortion (45 mates, 45 females) with no congenital malformations were included to the study. The abdominal aorta and its branches were dissected after latex solution colored with red ink had been injected into the vessels from the thoracic aorta. In all., 180 RA dissections were performed bilaterally in 90 cases and the anatomic variations were photographed. Right and left RAs were found to originate from the following levels according to the columna vertebratis, respectively: 3.8% and 1.9% tower T-12, 67.3% and 25.0% upper L-1, 9.6% and 28.8% mid L-1, 15.3% and 40.3 lower L-1, 3.8% and 3.8% upper 1/3 part of L-2 vertebra. The right RA originated from the lateral part and anterolateral wall of the abdominal aorta in 73.0% and 26.9% of cases white the lateral. and anterolateral watt origin percentages of left RA were 90.3% and 9.6%, respectively. The origin site of the right RA from the abdominal aorta was superior to, at the same level with, and inferior to that of the left RA in 53.8%, 34.6% and 11.5% of the cases, respectively. There were no variations in 75% of the cases whereas the remaining 25% had several variation patterns. The presented morphological results are as follows: A single hilar artery in 75% of the cases, double hilar arteries in 11.1%, an inferior polar artery in 10.5%, and a superior polar artery in 3.3% of specimens studied. Anatomical variations were observed more frequently among mate fetuses and on the right side. Knowledge of RA variations is important for surgeons in performing many procedures and may help to avoid clinical. complications, especially, during radiological examination and/or surgical approaches in the abdominal. region. (c) 2005 Elsevier GmbH. All rights reserved.Öğe A modified technique to bypass the maxillary artery to supraclinoid internal carotid artery by using radial artery graft: an anatomical study(HEADLEY BROTHERS LTD, 2005) Arbag, H; Ustun, ME; Buyukmumcu, M; Cicekcibasi, AE; Ulku, CHObjective: This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in treating ICA occlusions. Study design and setting: This method was carried out on five adult cadaver sides. The MA was reached 1-2 cm inferior to the crista infratemporalis, following a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2-3 cm lateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4 mm tipped drill. A radial artery graft was passed through the hole to the inside of the dura. Before giving the infraorbital artery branch, the MA was dissected from the surrounding tissue and transected. The proximal end of the graft was anastomosed end-to-end with the MA and the distal end of the graft end-to-side with the supraclinoid ICA. Results: The mean calibre of the MA was 2.6 +/- 0.3 mm. The mean calibre of the proximal end of the radial artery graft was 2.5 +/- 0.25 mm and the distal end was 2.35 +/- 0.2 mm. The mean length of the radial artery graft was 4.0 +/- 0.5cm. Conclusion: This study suggested that the cases with ICA occlusion, which require high blood flow, may be treated as an alternative to current bypass methods requiring long vein grafts.Öğe A morphometric study and variations on the lumbar arteries of human fetuses(ELSEVIER GMBH, 2005) Seker, M; Cicekcibasi, AE; Salbacak, A; Buyukmumcu, MLumbar arteries are in series with the posterior intercostal. arteries. The aim of this study has been to investigate the morphometric data on the abdominal aorta of the human fetus and define different types of origin variations of the Lumbar artery. Initially, the latex solution colored with red ink was injected into the thoracic aorta. The abdominal. aorta and its branches were dissected and examined bilaterally in 120 fetuses (ranging between 16 and 32 post-menstrual. weeks) and the anatomic variations recorded. Fourteen fetuses with variations were studied and photographed. The origins and morphologic variations of the lumbar arteries were defined and classified. The morphological. relationship of the Lumbar arteries to the abdominal. aorta and the Length and width (diameter) of the vessels were investigated by performing measurements using a digital calliper (mm). The frequency and the types of the different variations determined in the present study have been Listed. Abdominal aortic branches and lumbar artery aneurysms are rare lesions with potentially life-threatening consequences and they are difficult to access anatomically and formidable to manage operatively. During the performance of conventional or open surgical. replacement of an abdominal aortic aneurysm with prosthetic grafts, the surgeon needs precise knowledge of the anatomy of the abdominal. aortic branches and immediate retroperitoneal. structures. The variations on the lumbar arteries may have clinical importance. When this region is under diagnostic and/or surgical investigation using computed tomography scan or diagnostic angiography, the possibility of these variations should be take into consideration to avoid complications. (c) 2005 Elsevier GmbH. All rights reserved.Öğe Possibility of middle meningeal artery-to-petrous internal carotid artery bypass: An anatomic study(THIEME MEDICAL PUBL INC, 2004) Ustun, ME; Buyukmumcu, M; Seker, M; Karabulut, AK; Uysal, II; Ziylan, TThe possibility of creating a middle meningeal. artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in si cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 +/- 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 +/- 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA.Öğe Proximal superficial temporal artery to proximal middle cerebral artery bypass using a radial artery graft: an anatomic approach(SPRINGER, 2004) Buyukmumcu, M; Guney, O; Ustun, ME; Uysal, IK; Seker, MWe present the use of radial artery graft for bypass of the proximal superficial temporal artery to the proximal middle cerebral artery. Six adult cadaver sites were used bilaterally. After apterional incision, 2x2-cm minicraniectomy was performed which began 2 cm behind the zygomatic process of the frontal bone. The superficial temporal artery was transsected before exposing the zygomatico-orbital artery branch. The proximal side of the radial artery graft was anastomosed end-to-end to the proximal superficial temporal artery and the distal side end-to-side to the proximal middle cerebral artery. The mean calibers of the proximal superficial temporal artery and largest trunk of the middle cerebral artery were 2.25+/-0.35 mm and 2.3+/-0.3 mm, respectively. The average graft length was 85+/-5.5 mm. We conclude that such bypasses are simpler than proximal middle cerebral artery revascularization using long vein grafts. This method proves that the caliber of the proximal superficial temporal artery is more suited to providing sufficient flow than the distal superficial temporal artery, and the graft is short. Such bypasses to the middle cerebral artery may be an alternative to those from the distal superficial temporal artery or extracranial carotid artery.Öğe Radial artery graft for bypass of the maxillary to proximal posterior cerebral artery: An anatomical and technical study(TAYLOR & FRANCIS AS, 2004) Ulku, CH; Ustun, ME; Buyukmumcu, M; Cicekcibasi, AE; Ziylan, TObjective-To examine the use of a radial artery graft for bypass of the maxillary artery (MA) to proximal posterior cerebral artery (PCA) as an alternative to the external carotid artery (ECA) to PCA anastomosis used in posterior circulation bypass surgery. Materials and Methods-The method was applied to five adult cadaver sides bilaterally. The MA was easily found 1-2 cm beneath the infratemporal crest after a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally, 2-3 cm posterolateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4-mm tipped drill. After sylvian fissure, the interpedincular and ambient cisternae were opened and the P2 segment of the PCA appeared. The graft was passed through the hole and dura to reach the P2 segment. Proximal to the infraorbital artery branch, the MA was freed from the surrounding tissue and transected. The proximal side of the radial artery graft was anastomosed end-to-end with the MA and the distal side was anastomosed end-to-side with the P2 segment of the PCA. Results-The average diameter of the MA proximal to the infraorbital artery branch was 2.6+/-0.3 mm. The average diameter of the P2 was 2.2+/-0.2 mm. The average length of the graft was 47+/-5.2 mm. Conclusion-As MA to proximal PCA bypass uses a short radial graft and as the calibers of the MA and PCA are >2 mm such a bypass may provide sufficient blood flow and represents a reasonable alternative to "ECA to PCA'' bypass.Öğe A rare variation of the coeliac trunk(URBAN & FISCHER VERLAG, 2005) Cicekcibasi, AE; Uysal, II; Seker, M; Tuncer, I; Buyukmumcu, M; Salbacak, AThe hepatic, splenic and left gastric arteries are considered as the "main classic branches" of the coeliac trunk. During the routine dissections in the laboratory of the Anatomy Department in a 62-year-old mate cadaver, a rare variation, a coeliacomesenteric trunk was observed. This trunk gave rise to the left gastric, the common hepatic, the splenic, the left gastro-epiploic, the right and Left inferior phrenic arteries. The developmental and clinical significance of this anomalous vessel is discussed. (c) 2005 Elsevier GmbH. All rights reserved.Öğe Saphenous vein graft for bypass of the external carotid artery to supraclinoid internal carotid artery using a modified technique: An anatomical and technical study(TAYLOR & FRANCIS AS, 2004) Ulku, CH; Ustun, ME; Buyukmumcu, M; Cicekcibasi, AE; Uyar, YObjective - To investigate the use of a saphenous vein graft for bypass of the external carotid artery (ECA) to supraclinoid internal carotid artery (ICA) when the proximal middle cerebral artery (MCA) is not suitable for a bypass procedure. Material and Methods - Five adult cadaver sides were used. Dissection required a frontotemporal craniotomy and a zygomatic arch osteotomy, with a hole being opened 2 - 3 mm lateral to the foramen rotundum extradurally. The ECA was found easily via a second incision in the cervical region. The ophthalmic segment of the ICA was exposed by removal of the anterior clinoid process intradurally. After the dura over the hole was opened, the 7 - 8-cm long bypass graft was passed just behind the mandibula and through the hole inside the dura to reach the ICA. The ECA was then transected proximal to the occipital artery (OA) branch and the distal side of the vein graft was anastomosed end-to-end with the ECA and end-to-side with the supraclinoid ICA. Results - The mean diameter of the ECA proximal to the OA was 3.75 +/- 0.4 mm ( range 3.35 - 4.15 mm) and that of the supraclinoid ICA was 3.4 +/- 0.5 mm ( range 2.9 - 3.9 mm). The mean length of the venous graft was 7.5 +/- 0.5 cm ( range 7 - 8 cm). Conclusion - When high blood flow is needed and the proximal MCA is not suitable for a bypass, the bypass described herein may be an alternative to a superficial temporal to MCA bypass as well as to extracranial carotid artery to MCA or ICA bypasses, which both need long vein grafts.Öğe Superficial temporal artery graft for bypass of the maxillary to proximal middle cerebral artery using a transantral approach: an anatomical and technical study(TAYLOR & FRANCIS AS, 2005) Arbag, H; Cicekcibasi, AE; Uysal, II; Ustun, ME; Buyukmumcu, MConclusion. Using a transantral approach, we examined a new bypass of the maxillary artery ( MA) to proximal middle cerebral artery ( MCA). The caliber of the MA was suitable to provide sufficient blood flow. The length of the graft was shorter and it had a straighter course in the new technique than in previously described techniques. Objective. To examine a new bypass of the MA to proximal MCA using a transantral approach as an alternative to other forms of anterior circulation bypass surgery. Material and methods. The method was applied to five adult cadavers bilaterally. The MA and its branches were easily found after removal of the posterior sinus wall using a transantral approach. Then, a hole was created in the sphenoid bone 5 - 6 mm lateral to the posteroinferior edge of the superior orbital fissure extradurally. After the carotid and sylvian cisternae had been opened, the M2 segment of the MCA was exposed. The MA was transected just before the origin of the descending palatine artery branch. After opening the dura over the hole, the MA was passed through the hole to reach the intracranial cavity. The proximal side of the superficial temporal artery graft was anastomosed end- to- end with the MA and the distal side was anastomosed end- to- side with the M2 segment of the MCA. Results. The mean caliber of the MA was 2.4 +/- 0.3 mm before the origin of the descending palatine artery branch. The mean caliber of the largest trunk of the M2 segment of the MCA was 2.3 +/- 0.3 mm. The average length of the graft was 24 +/- 3 mm.
